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Doctor insights on:
Aortic Aneurysm

Aortic Aneurysm (Overview)

"Aneurysm" has scary implications for many people. It just means an enlargement of an artery. The problem is that when arteries (including the aorta) get too large, their walls become weak and prone to tear (dissection) or rupture. If this happens in the aorta it can be a catastrophe. Management of aortic aneurysms depends on where it is, how big, whether it's growing, and other clinical factors.

1

No:
An aortic dissection is a tear in the lining of the aorta, causing blood to leak into the aortic wall, causing pain and possibly hemodynamic issues. An aneurysm is an enlargement of the vessel to more than 2 times its normal size. Dissections may occur in aneurysms, and may become aneurysmal, but can occur independent of each other.
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Aortic Aneurysm (Overview)

"Aneurysm" has scary implications for many people. It just means an enlargement of an artery. The problem is that when arteries (including the aorta) get too large, their walls become weak and prone to tear (dissection) or rupture. If this happens in the aorta it can be a catastrophe. Management of aortic aneurysms depends on where it is, how big, whether it's growing, and other clinical factors.

3

Depends:
An aortic aneurysm can be the result of inherited conditions like marfan's syndrome. Conversley, aortic aneurysms may appear 'de novo' in those without a family history and only clinical risk factors such as atherosclerosis and hypertension. Since the relationship between genetics and environment is complex, if there is a family history one should always be extra vigilant and monitor.
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4

No:
Aneurysm is the dilation of your artery that can rupture if it gets too big overtime. A dissection is when the layers of your artery separate - generally associated with traumatic injuries (blunt or sharp), it is usually an acute event. Sometimes you can see dissection when the aneurysm starts to leak. Make friend with a vascular surgeon.
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5

Rarely has symptoms:
Most aneurysms are without symptoms until they begin to rupture or rapidly expand. Most are discovered on chest x-ray, ultrasound or ct scan looking for another problem typically, repair is not indicated in this location until the diameter is 5.5-6 cm.
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7

Involve renal artery:
A juxtarenal AAA is an aneurysm that involves or is associated with the renal arteries which are vital as they supply the kidneys with blood. The repair of this type of aneurysm is very challenging and so be sure and see a board certified Vascular Surgeon with a great deal of experience for consultation and treatment.
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10

Usually not:
Typically, an abdominal aneurysm causes no symptoms until it ruptures or rapidly expands. In the event of rupture, the pain is sudden and severe. Some enlarging aneurysms can cause back pain or flank pain, but that is less common.
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11

Perhaps:
Positive family history,
marfans or connective tissue disease,
hypertension,
smoking,
no absolute predictors, but good accurate exams and imaging are available.
Aneurysm can affect any part of the aorta - chest, abdomen pelvis and any named vessel!
so full history and exams are relevant.
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12

Known risk factors:
Certain aneurysms are caused by genetic predispositions that is caused by such conditions as marfan's syndrome. Otherwise the usual cardiovascular risk factors such as hypertension, diabetes, hypercholesterolemia and smoking.
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13

Dilated aorta:
Approx. 75% of aortic aneurysms are infrarenal. If the diameter of the aneurysm increases >= 0.5 cm/6mo. Period, early intervention advised. Once the aneurysm is 5cm or about twice the diameter of the non involved aorta, elective repair is advised. If 4cm dia and enlarging, repair advised to lower risk of death from exanguinating rupture. See your cardiovascular surgeon or vascular surgeon.
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14

Depends:
Aneurysms are dangerous because many people don't know they have them until they rupture. Screening is important for people over 65 with family history of aneurysm, smoking or htn. Ascending aneurysms and para visceral (upper abdomen) aneurysms are probably the most challenging to repair.
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15

X-ray:
Well sometimes it can be palpated if it is in the abdomen. Or in some cases and abnormal pulsation can even be visualized. Xrays, especially a ct scan will visualize and confirm it. An ultrasound would also demonstrate the aneurysm.
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16

Aneurysm/Dissection:
An aneurysm is an area where the aorta has ballooned out compared to the aorta below and above. The more expanded the greater the risk of rupture. Dissection is when there is a disruption of the inner layer of the aorta and blood can flow between the layers. This often will cause blockages of aortic branch vessels resulting in stroke, heart attack, and bowel/kidney infarction, etc.
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19

No:
At this stage, the use of d-dimer levels for AAA screening is experimental and may be used in conjunction with other screening modalities (ultrasound / ct scans). It would not be safe to only use d-dimer levels to screen for aaa's.
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20

The aorta is the largest artery in the body, leaving directly from the left ventricle of the heart to supply blood to the entire body. It is made of elastic tissue layers called "intima" and is subject to damage by high blood pressure, smoking, cholesterol, and inherited risk factors.
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An aneurysm is an abnormally dilated blood vessel, usually defined as a diameter 2x normal or larger. As weakened vessels get larger, there is risk of potential rupture or other complication.
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